Patient knowledge and care of surgical site infections at a selected regional hospital in KwaZulu-Natal Province, South Africa

Abstract

Background: Surgical site infection (SSI) is a common post-operative complication and can develop after a patient has been discharged from the surgical ward. Being comfortable with their SSI knowledge can empower patients and encourage them to engage in healthy behaviours that could lower the risk of this complication. Poor knowledge of wound care practice (WCP) among surgical patients could place them at risk of SSI, particularly once they have been discharged from hospital and are expected to care for their own surgical wounds. The study aimed to establish South African surgical patient knowledge and awareness of surgical site infections and wound care practices at a regional hospital in KwaZulu-Natal Province, South Africa. Methods: This prospective cross-sectional study involved two quantitative questionnaire surveys of general surgery patients at a regional hospital in Durban, South Africa (7 January 2025 - 24 April 2025). Each survey consisted of a socio-demographic questionnaire, and an adaption of a pre-existing questionnaire assessing comfort with SSI knowledge or assessing WCP. Univariate and multivariate data analyses, namely chi-squared tests and logistic regression, was used to test potential associations between patient characteristics and comfort with SSI knowledge or poor WCP knowledge. Results: Of the 255 survey participants included in the analysis, 48.2% did not feel comfortable with their SSI knowledge. Comfort with their SSI knowledge was predicted by: healthcare workers discussing SSI with them on two or more occasions (Odds Ratio, OR: 8.93), receipt of an informational flyer on SSI while in hospital (OR: 11.40), learning about SSI outside hospital via another clinic/healthcare worker (OR: 7.37), and learning about SSI outside hospital via another non-healthcare source (OR: 5.18). Of the 255 participants, 23.92% had poor WCP knowledge, the univariate analysis finding two potentially important patient characteristics being associated with poor knowledge: Black African race (p=0.153), and completion of high school education (p=0.001). When they were entered into a multivariate logistic regression model, only completion of high school was found to be a statistically significant predictor of poor WCP knowledge (OR: 0.34, p=0.001). Conclusion: Patients knowledge of SSI requires improvement, as it has implications for their wound care knowledge and practices, improving their quality of life and preventing avoidable illness and premature deaths. Measures to improve both should focus on providing verbal and hard copy messages while patients are still in hospital to enable them to ask questions and take information home.